Improving Engagement among Families Experiencing First-Episode Psychosis

改善首发精神病家庭的参与度

• 批准号: 10501705
• 负责人: Oladunni Oluwoye
• 金额: $ 5.38万
• 依托单位: WASHINGTON STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-13 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10501705
• 关键词: Address; Advisory Committees; Assertiveness; Caring; Client; Communication; Coordinated Specialty Care; Development; Effectiveness; Ensure; Evaluation; Evidence based practice; Family; Family member; Goals; Health Services; Individual; Intervention; Logistics; Mental Health Services; Mentored Research Scientist Development Award; Mentorship; Methodology; Modification; Motivation; Outcome; Patients; Play; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Self Determination; Site; Surveys; Testing; Training; Training Activity; Youth; acceptability and feasibility; base; career; career development; effective intervention; ethnic minority; evidence base; experience; first episode psychosis; implementation framework; implementation science; improved; intervention mapping; pilot test; programs; psychoeducation; racial and ethnic disparities; racial minority; recruit; theories; young adult

ABSTRACT Coordinated specialty care (CSC) interventions have demonstrated effectiveness in improving the short- and long-term outcomes of youth and young adults for first-episode psychosis (FEP). Youth with FEP have better outcomes when their families are involved in care. As a result, all CSC interventions for FEP include family psychoeducation as a core evidence-based component. Despite this fact, CSC programs generally report low levels (<50%) of engagement in family psychoeducation, and engagement of racial and ethnic minority families is even lower (<20%). Lack of family involvement is often driven by low motivation, cultural, logistical, and perceptual barriers, and perceived irrelevance of treatment. My preliminary findings among families of youth with FEP indicate that family members desired frequent communication and positive exchanges with clinicians and more assertive engagement and support. The proposed mixed-methods research project will further document the barriers to CSC. Using this information and input from a family and client Advisory Committee, I will develop, implement, and pilot-test a brief clinician-led family engagement intervention that will coincide with family psychoeducation for CSC programs for youth experiencing FEP. The framework for this study will blend core components of the Promoting Action on Research Implementation in Health Services (PARiHS), a collaborative implementation framework, and Intervention Mapping to ensure that the family engagement intervention fits within the context of CSC programs. The survey of family barriers and the family engagement intervention will be grounded in the Self-Determination Theory. I will first survey 200 family members of patients receiving CSC and assess demographic, cultural, perceptual, and logistical barriers and motivators that influence engagement in CSC programs for FEP. Then I will develop and assess the feasibility of the family engagement intervention in a CSC program and make modifications to improve the intervention. Finally, I will conduct a site-based stepped-wedge trial with 50 family members of youth with FEP recruited from five CSC programs to assess intervention acceptability and feasibility, as well as the impact of the intervention on engagement. The proposed study has the potential to address family engagement issues, with important implications for CSC programs and improved FEP outcomes for clients that will be further tested in a subsequent large R01 study. My proposed research plan integrates activities, formal training, and mentorship from experts (Drs. Michael McDonell, Leopoldo Cabassa, Michael Compton, Roberto Lewis-Fernández, Sterling McPherson, and Dennis Dyck) in FEP, family-focused evidence-based practices, family engagement, implementation science, and mixed- methodology. This Mentored Research Scientist Development Award ( K01) will build upon my previous training to allow me to pursue my long-term career goal to become an independent investigator with an established program of research focused on the development and implementation of effective family-focused evidence- based practices for FEP programs with an underlying emphasis on racial and ethnic disparities.

摘要 协调的专科护理（CSC）干预措施已证明在改善短期 青年和青年人首次精神病发作（FEP）的长期结果。患有FEP的年轻人 当他们的家人参与护理时，因此，CSC对FEP的所有干预措施都包括家庭 心理教育作为一个核心的循证组成部分。尽管如此，CSC计划通常报告低 参与家庭心理教育的水平（<50%），以及种族和少数民族家庭的参与 甚至更低（<20%）。缺乏家庭参与往往是由动机低、文化、后勤和 感知障碍和感知的治疗无关性。我在青少年家庭中的初步发现 FEP表明家庭成员希望与临床医生进行频繁的沟通和积极的交流， 更积极的参与和支持。拟议的混合方法研究项目将进一步记录 对CSC的障碍。利用这些信息和来自家庭和客户咨询委员会的意见，我将开发， 实施和试点测试一个简短的临床医生领导的家庭参与干预，将符合家庭 为遭受FEP的青少年提供心理教育。本研究的框架将融合核心 促进卫生服务研究实施行动（PARiHS）的组成部分，一个合作 实施框架和干预映射，以确保家庭参与干预适合 在CSC计划的背景下。家庭障碍调查和家庭参与干预将 以自决理论为基础。我会先调查200名接受CSC的病人家属， 并评估影响参与的人口统计学、文化、感知和后勤障碍和动机 在CSC的FEP项目中。然后，我将制定和评估家庭参与干预的可行性 并进行修改以改善干预。最后，我将进行一个基于网站的 从五个CSC项目中招募了50名患有FEP的青少年家庭成员进行阶梯楔形试验，以评估 干预的可接受性和可行性，以及干预对参与的影响。拟议 这项研究有可能解决家庭参与问题，对CSC计划具有重要意义， 为客户改善FEP结果，将在随后的大型R 01研究中进一步测试。我建议的 研究计划整合了活动、正式培训和专家指导（Michael McDonell博士， Leopoldo Cabassa，Michael Compton，Roberto Lewis-Fernández，Sterling麦克弗森，and Dennis Dyck）in FEP，以家庭为中心的循证实践，家庭参与，实施科学，以及混合- 方法论这 研究科学家发展奖（ K 01）将建立在我以前的培训基础上 让我追求我的长期职业目标，成为一名独立的调查员， 研究方案的重点是制定和实施有效的以家庭为重点的证据， 基于实践的FEP方案，强调种族和民族差异。

项目成果

The unique pathways to coordinate specialty care for Black families navigating early psychosis: A preliminary report.

协调黑人家庭应对早期精神病的专业护理的独特途径：初步报告。

• DOI: 10.1016/j.schres.2021.11.004
• 发表时间: 2023
• 期刊: Schizophrenia research
• 影响因子: 4.5
• 作者: Oluwoye,Oladunni;Stokes,Bryony
• 通讯作者: Stokes,Bryony

Exploring Provider Perspectives on Implementing Coordinated Specialty Care: A Qualitative Study.

探索提供者对实施协调专业护理的看法：一项定性研究。

• DOI: 10.1007/s10597-022-00939-5
• 发表时间: 2022-10
• 期刊: Community mental health journal
• 影响因子: 2.7
• 作者: Stokes B;Fraser E;Kriegel L;Oluwoye O
• 通讯作者: Oluwoye O

Structural Disadvantage and Culture, Race, and Ethnicity in Early Psychosis Services: International Provider Survey.

• DOI: 10.1176/appi.ps.202000211
• 发表时间: 2021-03-01
• 期刊: PSYCHIATRIC SERVICES
• 影响因子: 3.8
• 作者: Jones, Nev;Kamens, Sarah;Oluwoye, Oladunni;Mascayano, Franco;Perry, Chris;Manseau, Marc;Compton, Michael T.
• 通讯作者: Compton, Michael T.

Study protocol for a multi-level cross-sectional study on the equitable reach and implementation of coordinated specialty care for early psychosis.

• DOI: 10.1186/s43058-023-00476-6
• 发表时间: 2023-08-08
• 期刊: Implementation science communications

Recent substance use among clients with early psychosis and the potential to graduate from New Journeys.

患有早期精神病且有可能从新旅程毕业的客户最近的药物使用情况。

• DOI: 10.1111/eip.13386
• 发表时间: 2023
• 期刊: Early intervention in psychiatry
• 影响因子: 2
• 作者: Fraser,ElizabethR;Kordas,Gordon;Stokes,Bryony;McDonell,MichaelG;Oluwoye,Oladunni
• 通讯作者: Oluwoye,Oladunni